It is estimated that Medicare loses at least $60 billion annually to fraudulent activity.[1] This is not only costly for the Medicare program but can be devastating for the individual who falls victim to a scam.  We would like to share some helpful information about common Medicare scams and how to protect yourself against them.

Almost all Medicare recipients have received a call from someone saying they are from Medicare with an enticing offer to get “a free service or product” or “a new Medicare card”.  All you need to do it give your full name and Medicare number to verify in their system.  This is one of many scams people use to unlawfully get your Medicare number and potentially use it to submit fake medical claims to Medicare on your behalf and get paid on the services. 

Remember, Medicare will only call you if you have a call or request in to them and are awaiting a return call.  Scammers can be convincing and even threatening trying to get the Medicare number from you. 

Another form of fraud is when a healthcare provider bills Medicare for services or supplies that were not rendered.  Healthcare providers can misdiagnose a condition so they can bill or provide unnecessary tests or services.

Finally, insurance agents who represent Medicare plans can use deceptive practices to entice you to switch to their coverage, but when you find out the plan is not as advertised, your doctors don’t accept it and your prescriptions are not covered, the agent is no where to be found.  New Jersey Medicare Brokers is transparent in their work and will always make sure your healthcare providers and prescriptions are covered and provide clear information of health plan benefits.

Tips to keep yourself safe

1. Keep your Medicare number safe and only provide it to trusted healthcare providers. Don’t give your Medicare number over the phone to unsolicited callers. 

 

2. Review your Medicare statements for accuracy. Medicare will mail you quarterly statements with all your healthcare visits and the costs for these services.  If there are services you do not recognize you can reach out to the healthcare provider if you are familiar with them or call Medicare at 800-633-4227.

 

3. Review Protecting Yourself and Medicare from Fraud from the US Department of Health & Human Services, Center for Medicare and Medicaid Services.

Reporting Suspected Fraud

 

If you think you have experienced Medicare fraud, contact the fraud hotline of the Department of Health and Human Services Office of the Inspector General at 1-800-447-8477.

Additionally, New Jersey residents can report suspected fraud or scams through the Senior Medicare Patrol or by calling 877-767-4359. 

If you have any questions, you can always reach out to New Jersey Medicare Brokers for advice or help with reporting suspected scams or fraud.

 

[1] Liebau, Nicole. “Medicare Fraud, Errors, and Abuse Can Cost in Dollars and Health.” USC Center for Elder Justice, https://eldermistreatment.usc.edu/medicare-fraud-errors-and-abuse-can-cost-in-dollars-and-health/ . Accessed 28 May 2022.